Image Source: NEC Corporation of America. Source License: CC BY 2.0. Adaptations: cropped.

A public health database includes accurate, detailed and current information accessible to planners and decision-makers that can be used to inform policies, programming, and services that lead to policies to encourage “healthy communities”—meaning:  improved health outcomes for individuals and for the community as a whole. Health data must be collected and maintained to a level of geographic and demographic specificity in order to remain actionable, have meaningful impact, and allow progress to be tracked through health and quality of life indicators.

Why is this important to your community?

Although available health data for the CONNECT region as a whole indicates that the current population maintains a relatively “average” level of health, more detailed data exposes significant disparities in health by race as well as by socioeconomic status and geographic location. According to the CONNECT Our Future Public Health work group, wherever health data by race is available, disparities between the white, non-Hispanic and African American, non-Hispanic populations are striking. These disparities are most evident in terms of women and children’s health and the causes of death throughout the region. The absence of county-level health data for the region’s Latino population and other racial or ethnic groups limits discussion of social indicators of health to the African American population and to economically disadvantaged populations that were not otherwise distinguished by race or ethnicity.

More complete health data is needed for county health indicators to be more closely examined, and so that the relationship of these indicators to social, economic, and demographic indicators may be assessed. For this to occur, state and local agencies need to expand local behavioral risk factor surveys, youth risk behavior surveys, and other locally-focused data collection efforts to capture more local data—especially for minorities and other groups within the population. County Health Departments are required to do Community Assessments to collect, summarize, and report on key health indicators in the community. Local government officials, such as planners, park and recreation officials, and engineers can be critical partners in this effort and can benefit from the data collected.

But this is not simply a research exercise. Public health disparities impact our region’s, and our nation’s resources—not only in terms of money, but also in lost productivity and in human and social capital. Without adequate information and analysis, damaging disparities and their causes cannot be identified, so policies and programs that target, environmental and behavioral causes of disparities cannot be developed to address them.

How does it work?

According to the Centers for Disease Control and Prevention (CDC), “ongoing systematic collection, analysis, and interpretation of health data is essential to the planning, implementation, and evaluation of public health practice, and closely integrated with the timely dissemination of these data to those who need to know.”  Growing healthy communities requires collaboration across sectors, particularly related to data collection and information access. Healthy data for healthy communities requires integration of datasets from a variety of sources at a variety of scales, often collected in isolation from and not informed by a broader community health vision. Each state, organization, or local agency usually collects data relative to its individual policy area, and significant gaps in data may exist for smaller scale areas. Establishing a thorough, usable health dataset—including resource-based as well as community-based data—with the goal of sustaining healthy communities will inform and focus efforts and allow outcomes to be accurately measured.

Ready to get started?

Using the Tool

Establishing a functional health dataset that serves as a resource to improve community health requires a fundamental understanding of the existing issues in the community, as well as the data that is readily available or able to be collected. The commitment of an organized body of stakeholders that can approach data collection from a variety of perspectives is also crucial, with each of these groups able to collect, analyze, distribute, and maintain relevant data. The following steps outline a public health surveillance approach to growing the availability of and access to health data that supports creating healthy communities.
  • Organize Key Contributors and Establish Goals Establish a meeting or retreat to discuss the establishment of the data that must be collected to achieve a comprehensive, actionable database. Include individuals from both the public health perspective, urban planners, including transportation planners, and influential non-profits, if applicable. Discuss the communities in need or the disparities that are known, and identify the data that will be needed to identify such gaps in order to develop policies to amend them. Identify a set of healthy community goals that data would help support as a starting point, that can be refined as more data is known.
  • Identify Existing Data Create a comprehensive inventory of all “healthy communities” data available. This step includes identifying data sources, recording how often data is collected, organizing information according to geographic scale, and assessing the potential for benchmarking with comparable state and national datasets. The outcomes of this step should be organized as a report and distributed among service providers and representatives from the various data sources to ensure that all relevant information has been recorded and is accurately accounted for, and to ensure that the local health community has confidence in the accuracy of the data (does it pass the “smell test?”). Examples of data include: Access to health care facilities; Percentage of population with insurance and/or receiving Medicare or Medicaid benefits; Access to Parks (distance from households to parks); Amount of time spent engaging in physical activity; Access to Healthy Foods within the neighborhood (location of grocery stores or others selling fresh produce);  Air Quality; Location of housing of population groups in relation to environmentally hazardous areas; Quality of the housing stock;  Crime and Violence data by neighborhood; Transportation Options by neighborhood and Frequency of Service; Prevalence of mental health cases and access to services for mental health patients, among others.
  • Select Appropriate Organizations/Agencies Once the analysis of the existing data is complete, identify additional organizations and agencies that can help fill information gaps. Individuals within this new group may have access to additional data sources and will add to the diversity of expertise and insight needed to establishing goals for future data collection. A coalition of data providers and data users should be organized in order to establish goals, implement future data collection efforts, and maintain an ongoing open dialogue not only about the data, but about what it says about community health issues and needs, and how they might be addressed.
  • Acquire Tools for Collection, Analysis, and Dissemination Depending on the level of detail and statistical accuracy identified as necessary by the coalition, new data collection tools may be required. Research and educational institutions usually maintain their individual Internal Review Boards with standards of practice for acquiring community-based data. Determine the level of accuracy that is needed to implement policy and actions from a planning perspective that may differ from statistically-valid needs of public health or medical institutions and research. Discuss how this may impact timelines for completing research, as well as required funds and staff dedication.
  • Implement survey/surveillance system/data inquiry Collect the necessary data through standard survey practices outlined and approved by the coalition. These surveys or surveillance systems may focus on individual behavior patterns, identifying risks, surveying local populations, organizing focus groups, or purchasing data from existing sources.
  • Evaluate the effectiveness of the implementation Once the data is collected and organized, the coalition should review the results for accuracy and relevance to informing the identified goals.
  • Analyze the results Where possible, the results should be summarized in reports for potential use across a variety of platforms and among a variety of audiences. Health data as it relates to healthy communities can be of importance to a wide range of users, including many outside of the public health and planning fields. To be useful, it must be reported accurately but in easy-to-understand terms, and with clear statements as to its relevance for the particular audience. For example, data on obesity (lacking in the CONNECT region) must be reported in terms of how obesity can be addressed through changes in public policy, in the built environment, programmatic changes in schools or workplaces, etc. Data without recommendations attached are often easy to ignore.
  • Disseminate results Work with the coalition to develop an outreach strategy that targets potential data users.

Where has it worked?

PHMC / CHDB - Philadelphia, PA

Public Health DatabaseImage Source: Public Health Management Corp.;.

 

Contact

Johanna Trowbridge
215-985-2548
johannat@phmc.org

About the Program

Recognizing that local, population-based data was generally unavailable for health planning, policy, and program development, and that this missing information greatly reduced the capacity of local health and social service organizations to plan and design health programs to address the needs of local residents and communities, the Public Health Management Corporation (PHMC) created the Community Health Data Base (CHDB).

The central component of the Community Health Data Base is the Southeastern Pennsylvania Household Health Survey, an extensive health survey that provides timely information on more than 13,000 residents—children and adults—living in Southeast Pennsylvania. With the first survey conducted in 1983, and recurring biannually since 1994, PHMC targets key information about health status, personal health behaviors, and access to and utilization of area health services, as well as health screening information, health insurance status, women’s health, child health, and older adult health and social support needs. Unlike other health data sources, this information is available at the census tract cluster, ZIP code cluster, county, and regional levels.

Why it works

Together with U.S. Census and vital statistics data maintained through PHMC, the Southeastern Pennsylvania Household Health Survey has become a unique, critical resource for area health and social service agencies. It provides:

  • Local data, not extrapolations based on national or state data
  • Data that are community-based rather than resource-based
  • Data that can be examined by different levels of geography, including census tract, health district, Minor Civil Division, and ZIP code, as well as by county and region
  • Longitudinal data that can be used as a baseline to measure changes in health, social status and access to care over time

Survey outcomes are statistically valid and available to member organizations to:

  • Assess a community’s health status
  • Identify current and future health needs
  • Provide baseline information to monitor progress toward goals, including many Healthy People 2010 goals
  • Target, develop and market programs and services to meet the needs of the community

According to PHMC, the need for population-based data has become ever more urgent and apparent over the past decade. Data available through the Community Health Data Base helps health care providers understand changes in the environment, such as shifts in population composition, changes in federal welfare entitlements, and the effects of organizational restructuring and financing of health care. PHMC maintains the Community Health Data Base as an impartial data source for investigating these issues and for monitoring progress toward public health goals, such as Healthy People 2010 and Healthy People 2020 benchmarks. Additionally, partners in the community use CHBD’s data to implement real community change. As an example, the Community Health Education program at Crozer-Keystone Health System—one of the largest health care providers in the area—uses the data to plan outreach strategies and determine which neighborhoods and portions of the neighborhood need policy or program intervention, such as maternal and infant health, improving cardiovascular health, and early cancer detection. The data also helps organizations easily target grant funding, which is a key tool in implementing programs to produce discernable progress in overall community wellness.

http://www.chdbdata.org

http://phmc.org